New Insights into Autonomic Nerve Preservation in High Ligation of the Inferior Mesenteric Artery in Laparoscopic Surgery for Colorectal Cancer

Yang, Xiaofei; Li, Guoxin; Luo, Guangheng; Zhang, Shizhen; Ding, Zhengnian

doi:10.7314/apjcp.2014.15.6.2533

Cited by 6 publications

(6 citation statements)

References 30 publications

(41 reference statements)

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“…In this study, it was found that the main right trunk of the IMP did not cross the root of the IMA, and the left trunk of the IMP crossed over the IMA, which is consistent with previous studies ( 15 – 17 ). In contrast, previous anatomical studies of cadavers have neglected the existence of vascular sheaths.…”

Section: Discussionsupporting

confidence: 93%

“…At present, anatomical studies of the relationship between the root of the IMA and the autonomic nerve plexus are very limited. Previous studies ( 15 – 17 ) have shown that the right trunk of the IMP is located relatively far from the root of the IMA and does not cross the root of the IMA, while the left trunk of the IMP crosses over the IMA ( Figure 1 ). Therefore, high ligation of the IMA may be more likely to cause damage to the left trunk of the IMP.…”

Section: Introductionmentioning

confidence: 82%

“…Yang et al. ( 17 ) suggested that high ligation of the IMA should be performed at a distance distal to the intersection of the left trunk of the IMP and the IMA to protect the left trunk of the IMP. However, whether the no.…”

Section: Discussionmentioning

confidence: 99%

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An Intrasheath Separation Technique for Nerve-Sparing High Ligation of the Inferior Mesenteric Artery in Colorectal Cancer Surgery

et al. 2021

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PurposeTo investigate the relationship between the left trunk of the inferior mesenteric plexus (IMP) and the vascular sheath of the inferior mesenteric artery (IMA) and to explore anatomical evidence for autonomic nerve preservation during high ligation of the IMA in colorectal cancer surgery.MethodsWe evaluated the relationship in 23 consecutive cases of laparoscopic or robotic colorectal surgery with high ligation of the IMA at our institute. Anatomical dissection was performed on 5 formalin-fixed abdominal specimens. A novel anatomical evidence-based operative technique was proposed.ResultsAnatomical observation showed that the left trunk of the IMP was closely connected with the IMA and was involved in the composition of the vascular sheath. Based on anatomical evidence, we present a novel operative technique for nerve-sparing high ligation of the IMA that was successfully performed in 45 colorectal cancer surgeries with no intraoperative complications and satisfactory postoperative urogenital functional outcomes.ConclusionThe left trunk of the IMP is involved in the composition of the IMA vascular sheath. This novel anatomical evidence-based operative technique for nerve-sparing high ligation of the IMA is technically safe and feasible.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 82%

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An Intrasheath Separation Technique for Nerve-Sparing High Ligation of the Inferior Mesenteric Artery in Colorectal Cancer Surgery

et al. 2021

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“…The HT is credited for ease of lymph node dissection (LND) around IMA for staging and oncological outcome plus tension-free anastomosis of the remaining colon. 3 , 4 The compromise of blood supply leading to colon ischemia, 5 hypoperfusion and anastomotic leakage (AL), 6 , 7 damage to superior hypogastric plexus, 8 and genitourinary defecatory functions 9 are some concerns for the HT. The LT has shown a decrease in leakage with the comparable oncological outcome and 5-year long-term survival.…”

Section: Introductionmentioning

confidence: 99%

Lymphadenectomy Around Inferior Mesenteric Artery in Low-Tie vs High-Tie Laparoscopic Anterior Resection: Short- and Long-Term Outcome of a Cohort of 614 Rectal Cancers

Luo¹,

Yu²,

Huang³

et al. 2021

CMAR

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Background: Preservation of the left colic artery in low-tie (LT) of inferior mesenteric artery remains controversial compared to high-tie (HT) in the colon and rectal cancers, for lymph node dissection, anastomotic leakage, and oncological outcome. This cohort study aims to analyze short-and long-term outcomes of laparoscopic anterior resections in LT vs HT for rectal cancers. Methods: We analyzed a cohort of laparoscopic AR for RC from 2013 to 2016 at Renji Hospital, Shanghai, China. Short-and long-term outcome in LT vs HT group were compared for clinico-demographic characteristics, operative-time, lymph node dissection, short-term 30day outcome, and long-term 3-and 5-year overall survival as well as disease-free survival. The x 2 , t-test, and logistic regressions analysis were used and p<0.05 was considered significant. Results: The cohort consisted of 614 laparoscopic AR with LT (236) and HT (378). The clinicodemographic characteristics were comparable among the groups. The surgery took longer in LT. The yield of LND was similar. Leakage occurred in 12.21% (n=75). Leakage was fewer in LT than HT, 8.89% vs 14.28%, p=0.047. The postoperative severe complications were higher in HT. The 30-day mortality was nil. The long-term 3-and 5-year overall survival and disease-free survival were similar in LT and HT. Conclusion:The LT with preservation of left colic artery had similar lymph node yield, but lower leakage and complications than HT in laparoscopic anterior resections for rectal cancers. The long-term 3-and 5-year overall and disease-free survival were similar in the two groups.

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“…Laparoscopic surgery has been steadily established as a standard operative procedure for patients with colorectal cancer and advantages of this minimal invasive surgery have been confirmed by several studies (Yang et al, 2014;Zhou et al, 2004;Lujan et al, 2009;). In comparison to open surgery, there is less postoperative pain, quicker recovery, less blood loss and so on (King et al, 2006;Ng et al, 2008).…”

Section: Discussionmentioning

confidence: 96%

Seniors Have a Better Learning Curve for Laparoscopic Colorectal Cancer Resection

Zhang¹,

Wang²,

Liang³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Purpose: This study was designed to evaluate the outcomes of laparoscopic colorectal resection in a period of learning curve completed by surgeons with different experience and aptitudes with a view to making clear whether seniors had a better learning curve compared with juniors. Methods: From May 2010 to August 2012, the first twenty patients underwent laparoscopic colorectal resection completed by each surgeon were selected for analysis retrospectively. A total of 240 patients treated by 5 seniors and 7 juniors were divided into the senior group (n=100) and the junior group (n=140). The short-term outcomes of laparoscopic surgery of the two groups were compared. Results: The mean numbers of lymph nodes harvested were 21.2±11.0 in the senior group and 17.3±11.5 in the junior group (p=0.010); The mean operative times were 187.9±60.0min as compared to 231.3±55.7 min (p=0.006), and blood loss values were 177.0±100.7ml and 234.0±185ml, respectively (p=0.001); Conversion rate in the senior group was obviously lower than in the junior group (10.0% vs 20.7%, p=0.027) and the mean time to passing of first flatus were 3.3±0.9 and 3.8±0.9 days (p=0.001). For low rectal cancer, the sphincter preserving rates were 68.7% and 35.3% (p=0.027). Conclusions: Seniors could perform laparoscopic colorectal resection with relatively better oncological outcomes and quicker recovery, and seniors could master the laparoscopic skill more easily and quickly. Seniors had a better learning curve for laparoscopic colorectal cancer resection compared to juniors.

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New Insights into Autonomic Nerve Preservation in High Ligation of the Inferior Mesenteric Artery in Laparoscopic Surgery for Colorectal Cancer

Cited by 6 publications

References 30 publications

An Intrasheath Separation Technique for Nerve-Sparing High Ligation of the Inferior Mesenteric Artery in Colorectal Cancer Surgery

An Intrasheath Separation Technique for Nerve-Sparing High Ligation of the Inferior Mesenteric Artery in Colorectal Cancer Surgery

Lymphadenectomy Around Inferior Mesenteric Artery in Low-Tie vs High-Tie Laparoscopic Anterior Resection: Short- and Long-Term Outcome of a Cohort of 614 Rectal Cancers

Seniors Have a Better Learning Curve for Laparoscopic Colorectal Cancer Resection

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